Effect of Mineralocorticoid Receptor Antagonists on the Prognosis of Patients with Ventricular Tachyarrhythmias
Introduction: The study sought to assess the effect of treatment with mineralocorticoid receptor antagonists (MRAs) on long-term prognosis of patients with systolic heart failure (HF) surviving index episodes of ventricular tachyarrhythmias. Methods: A large retrospective registry was used including...
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| Veröffentlicht in: | Pharmacology 2022-01, Vol.107 (1-2), p.35-45 |
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| creator | Schupp, Tobias von Zworowsky, Max Reiser, Linda Abumayyaleh, Mohammad Weidner, Kathrin Mashayekhi, Kambis Bertsch, Thomas Abba, Mohammed L. Akin, Ibrahim Behnes, Michael |
| description | Introduction: The study sought to assess the effect of treatment with mineralocorticoid receptor antagonists (MRAs) on long-term prognosis of patients with systolic heart failure (HF) surviving index episodes of ventricular tachyarrhythmias. Methods: A large retrospective registry was used including consecutive HF patients with left ventricular ejection fraction |
| doi_str_mv | 10.1159/000520310 |
| format | Article |
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Methods: A large retrospective registry was used including consecutive HF patients with left ventricular ejection fraction <45% and index episodes of ventricular tachyarrhythmias from 2002 to 2015. The primary endpoint was all-cause mortality at 3 years and secondary endpoints were rehospitalization, as well as the composite endpoint consisting of recurrent ventricular tachyarrhythmias, sudden cardiac death and appropriate implantabe cardioverter defibrillator (ICD) therapies at 3 years. Results: 748 patients were included, 20% treated with MRA and 80% without. At 3 years, treatment with MRA was not associated with improved all-cause mortality (22% vs. 24%, log-rank p = 0.968; hazard ratio (HR) = 1.008; 95% CI 0.690–1.472; p = 0.968). Accordingly, risk of the composite endpoint (28% vs. 27%; HR = 1.131; 95% CI 0.806–1.589; p = 0.476) and first cardiac rehospitalization (24% vs. 22%; HR = 1.139; 95% CI 0.788–1.648; p = 0.489) were not affected by treatment with MRA. Conclusion: In patients with ventricular tachyarrhythmias, treatment with MRA was not associated with improved all-cause mortality at 3 years. The therapeutic effect of MRA treatment in patients with ventricular tachyarrhythmias needs to be reinvestigated within further randomized controlled trials.</description><identifier>ISSN: 0031-7012</identifier><identifier>EISSN: 1423-0313</identifier><identifier>DOI: 10.1159/000520310</identifier><identifier>PMID: 34879385</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiac patients ; Case-Control Studies ; Eplerenone - pharmacology ; Eplerenone - therapeutic use ; Female ; Germany ; Health aspects ; Heart ; Humans ; Male ; Middle Aged ; Mineralocorticoid Receptor Antagonists - pharmacology ; Mineralocorticoid Receptor Antagonists - therapeutic use ; Mortality ; Multivariate Analysis ; Prognosis ; Rankings ; Registries ; Research Article ; Retrospective Studies ; Spironolactone ; Spironolactone - pharmacology ; Spironolactone - therapeutic use ; Tachycardia ; Tachycardia, Ventricular - diagnosis ; Tachycardia, Ventricular - drug therapy ; Tachycardia, Ventricular - mortality ; Young Adult</subject><ispartof>Pharmacology, 2022-01, Vol.107 (1-2), p.35-45</ispartof><rights>2021 The Author(s) Published by S. Karger AG, Basel</rights><rights>2021 The Author(s) Published by S. Karger AG, Basel.</rights><rights>COPYRIGHT 2022 S. Karger AG</rights><rights>Copyright © 2021 by S. Karger AG, Basel 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-7ee1fc90e5b1ca8af4c42b591314c5d1e34bfb0fa48898d018c77fa22dc474c73</citedby><cites>FETCH-LOGICAL-c491t-7ee1fc90e5b1ca8af4c42b591314c5d1e34bfb0fa48898d018c77fa22dc474c73</cites><orcidid>0000-0001-8171-7617 ; 0000-0001-5970-0093</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34879385$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schupp, Tobias</creatorcontrib><creatorcontrib>von Zworowsky, Max</creatorcontrib><creatorcontrib>Reiser, Linda</creatorcontrib><creatorcontrib>Abumayyaleh, Mohammad</creatorcontrib><creatorcontrib>Weidner, Kathrin</creatorcontrib><creatorcontrib>Mashayekhi, Kambis</creatorcontrib><creatorcontrib>Bertsch, Thomas</creatorcontrib><creatorcontrib>Abba, Mohammed L.</creatorcontrib><creatorcontrib>Akin, Ibrahim</creatorcontrib><creatorcontrib>Behnes, Michael</creatorcontrib><title>Effect of Mineralocorticoid Receptor Antagonists on the Prognosis of Patients with Ventricular Tachyarrhythmias</title><title>Pharmacology</title><addtitle>Pharmacology</addtitle><description>Introduction: The study sought to assess the effect of treatment with mineralocorticoid receptor antagonists (MRAs) on long-term prognosis of patients with systolic heart failure (HF) surviving index episodes of ventricular tachyarrhythmias. Methods: A large retrospective registry was used including consecutive HF patients with left ventricular ejection fraction <45% and index episodes of ventricular tachyarrhythmias from 2002 to 2015. The primary endpoint was all-cause mortality at 3 years and secondary endpoints were rehospitalization, as well as the composite endpoint consisting of recurrent ventricular tachyarrhythmias, sudden cardiac death and appropriate implantabe cardioverter defibrillator (ICD) therapies at 3 years. Results: 748 patients were included, 20% treated with MRA and 80% without. At 3 years, treatment with MRA was not associated with improved all-cause mortality (22% vs. 24%, log-rank p = 0.968; hazard ratio (HR) = 1.008; 95% CI 0.690–1.472; p = 0.968). Accordingly, risk of the composite endpoint (28% vs. 27%; HR = 1.131; 95% CI 0.806–1.589; p = 0.476) and first cardiac rehospitalization (24% vs. 22%; HR = 1.139; 95% CI 0.788–1.648; p = 0.489) were not affected by treatment with MRA. Conclusion: In patients with ventricular tachyarrhythmias, treatment with MRA was not associated with improved all-cause mortality at 3 years. The therapeutic effect of MRA treatment in patients with ventricular tachyarrhythmias needs to be reinvestigated within further randomized controlled trials.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiac patients</subject><subject>Case-Control Studies</subject><subject>Eplerenone - pharmacology</subject><subject>Eplerenone - therapeutic use</subject><subject>Female</subject><subject>Germany</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mineralocorticoid Receptor Antagonists - pharmacology</subject><subject>Mineralocorticoid Receptor Antagonists - therapeutic use</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Prognosis</subject><subject>Rankings</subject><subject>Registries</subject><subject>Research Article</subject><subject>Retrospective Studies</subject><subject>Spironolactone</subject><subject>Spironolactone - pharmacology</subject><subject>Spironolactone - therapeutic use</subject><subject>Tachycardia</subject><subject>Tachycardia, Ventricular - diagnosis</subject><subject>Tachycardia, Ventricular - drug therapy</subject><subject>Tachycardia, Ventricular - mortality</subject><subject>Young Adult</subject><issn>0031-7012</issn><issn>1423-0313</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>EIF</sourceid><recordid>eNptkd9rFDEQx4Mo9lp98F1kwRd92Jpf22RfhKNUK1Q8pPoastnJbnQvOZOccv99s9x5Wih5mCHzme98k0HoBcHnhDTtO4xxQzEj-BFaEE5ZXXL2GC1wibXAhJ6g05R-FOyCCvkUnTAuRctks0DhylowuQq2-uw8RD0FE2J2Jri--goGNjnEaumzHoJ3Kacq-CqPUK1iGHxILs2tK50d-FL84_JYfS9pdGY76VjdajPudIzjLo9rp9Mz9MTqKcHzQzxD3z5c3V5e1zdfPn66XN7Uhrck1wKAWNNiaDpitNSWG067piWMcNP0BBjvbIet5lK2ssdEGiGsprQ3XHAj2Bl6v9fdbLs19Ga2pCe1iW6t404F7dT9inejGsJvJSXFnNEi8OYgEMOvLaSs1i4ZmCbtIWyTohcEY8kYJwV9vUcHPYFy3oaiaGZcLQVuW0xFMzs6f4Aqp4d1-W4P1pX7ew1v9w0mhpQi2KN7gtW8d3Xce2Ff_f_cI_l30f88_tRxgHgEVtfLvYTa9LZQLx-kDlPuAPgcvqI</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Schupp, Tobias</creator><creator>von Zworowsky, Max</creator><creator>Reiser, Linda</creator><creator>Abumayyaleh, Mohammad</creator><creator>Weidner, Kathrin</creator><creator>Mashayekhi, Kambis</creator><creator>Bertsch, Thomas</creator><creator>Abba, Mohammed L.</creator><creator>Akin, Ibrahim</creator><creator>Behnes, Michael</creator><general>S. Karger AG</general><scope>M--</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8171-7617</orcidid><orcidid>https://orcid.org/0000-0001-5970-0093</orcidid></search><sort><creationdate>20220101</creationdate><title>Effect of Mineralocorticoid Receptor Antagonists on the Prognosis of Patients with Ventricular Tachyarrhythmias</title><author>Schupp, Tobias ; von Zworowsky, Max ; Reiser, Linda ; Abumayyaleh, Mohammad ; Weidner, Kathrin ; Mashayekhi, Kambis ; Bertsch, Thomas ; Abba, Mohammed L. ; Akin, Ibrahim ; Behnes, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-7ee1fc90e5b1ca8af4c42b591314c5d1e34bfb0fa48898d018c77fa22dc474c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiac patients</topic><topic>Case-Control Studies</topic><topic>Eplerenone - pharmacology</topic><topic>Eplerenone - therapeutic use</topic><topic>Female</topic><topic>Germany</topic><topic>Health aspects</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mineralocorticoid Receptor Antagonists - pharmacology</topic><topic>Mineralocorticoid Receptor Antagonists - therapeutic use</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Prognosis</topic><topic>Rankings</topic><topic>Registries</topic><topic>Research Article</topic><topic>Retrospective Studies</topic><topic>Spironolactone</topic><topic>Spironolactone - pharmacology</topic><topic>Spironolactone - therapeutic use</topic><topic>Tachycardia</topic><topic>Tachycardia, Ventricular - diagnosis</topic><topic>Tachycardia, Ventricular - drug therapy</topic><topic>Tachycardia, Ventricular - mortality</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schupp, Tobias</creatorcontrib><creatorcontrib>von Zworowsky, Max</creatorcontrib><creatorcontrib>Reiser, Linda</creatorcontrib><creatorcontrib>Abumayyaleh, Mohammad</creatorcontrib><creatorcontrib>Weidner, Kathrin</creatorcontrib><creatorcontrib>Mashayekhi, Kambis</creatorcontrib><creatorcontrib>Bertsch, Thomas</creatorcontrib><creatorcontrib>Abba, Mohammed L.</creatorcontrib><creatorcontrib>Akin, Ibrahim</creatorcontrib><creatorcontrib>Behnes, Michael</creatorcontrib><collection>Karger Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schupp, Tobias</au><au>von Zworowsky, Max</au><au>Reiser, Linda</au><au>Abumayyaleh, Mohammad</au><au>Weidner, Kathrin</au><au>Mashayekhi, Kambis</au><au>Bertsch, Thomas</au><au>Abba, Mohammed L.</au><au>Akin, Ibrahim</au><au>Behnes, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Mineralocorticoid Receptor Antagonists on the Prognosis of Patients with Ventricular Tachyarrhythmias</atitle><jtitle>Pharmacology</jtitle><addtitle>Pharmacology</addtitle><date>2022-01-01</date><risdate>2022</risdate><volume>107</volume><issue>1-2</issue><spage>35</spage><epage>45</epage><pages>35-45</pages><issn>0031-7012</issn><eissn>1423-0313</eissn><abstract>Introduction: The study sought to assess the effect of treatment with mineralocorticoid receptor antagonists (MRAs) on long-term prognosis of patients with systolic heart failure (HF) surviving index episodes of ventricular tachyarrhythmias. Methods: A large retrospective registry was used including consecutive HF patients with left ventricular ejection fraction <45% and index episodes of ventricular tachyarrhythmias from 2002 to 2015. The primary endpoint was all-cause mortality at 3 years and secondary endpoints were rehospitalization, as well as the composite endpoint consisting of recurrent ventricular tachyarrhythmias, sudden cardiac death and appropriate implantabe cardioverter defibrillator (ICD) therapies at 3 years. Results: 748 patients were included, 20% treated with MRA and 80% without. At 3 years, treatment with MRA was not associated with improved all-cause mortality (22% vs. 24%, log-rank p = 0.968; hazard ratio (HR) = 1.008; 95% CI 0.690–1.472; p = 0.968). Accordingly, risk of the composite endpoint (28% vs. 27%; HR = 1.131; 95% CI 0.806–1.589; p = 0.476) and first cardiac rehospitalization (24% vs. 22%; HR = 1.139; 95% CI 0.788–1.648; p = 0.489) were not affected by treatment with MRA. Conclusion: In patients with ventricular tachyarrhythmias, treatment with MRA was not associated with improved all-cause mortality at 3 years. The therapeutic effect of MRA treatment in patients with ventricular tachyarrhythmias needs to be reinvestigated within further randomized controlled trials.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>34879385</pmid><doi>10.1159/000520310</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8171-7617</orcidid><orcidid>https://orcid.org/0000-0001-5970-0093</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Cardiac patients Case-Control Studies Eplerenone - pharmacology Eplerenone - therapeutic use Female Germany Health aspects Heart Humans Male Middle Aged Mineralocorticoid Receptor Antagonists - pharmacology Mineralocorticoid Receptor Antagonists - therapeutic use Mortality Multivariate Analysis Prognosis Rankings Registries Research Article Retrospective Studies Spironolactone Spironolactone - pharmacology Spironolactone - therapeutic use Tachycardia Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - drug therapy Tachycardia, Ventricular - mortality Young Adult |
| title | Effect of Mineralocorticoid Receptor Antagonists on the Prognosis of Patients with Ventricular Tachyarrhythmias |
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